Lindsay Clancy knew ‘right from wrong’ during killings, psychiatrist testifies at trial ahead of closing arguments

The judge ended the charge conference by asking both parties how long their closing arguments might take.

Reddington told Sullivan: "I'm usually pretty quick. I would say half an hour."

Prosecutors said they are likely to take an hour.

Judge William Sullivan went over the jury instructions with both parties ahead of tomorrow's closing statements.

The parties largely agreed on the instructions for first-degree murder, with prosecutors signing off on language that the charges are for "deliberate premeditation and extreme atrocity or cruelty."

But the defense pushed for instructions on involuntary manslaughter as a lesser charge the jury may agree on if it cannot decide on the three murder charges.

Prosecutors objected the involuntary manslaughter instructions, as well as Reddington's request to include instructions on a Bowden charge, which would let jurors find the police investigation was not sufficient. The two parties agreed to eliminate references to "voluntary intoxication."

The final part of the trial before closing arguments — the charge conference — has started.

The prosecution, the defense and the judge will iron out the specifics of instructions given to the jury before it begins deliberations.

Clancy's defense lawyer believes his client is aware of the social media chatter surrounding her ongoing case.

Asked by NBC News whether he thought she knew how much attention the case has been getting on social media, Reddington said: "I would imagine anybody would be. It's been quite publicized."

Since the trial began, online sleuths and true-crime fanatics have been dissecting every detail of the proceedings, trying to piece together what happened on Jan. 24, 2023. Conspiracy theories have gone viral, prompting rebuttals of claims from reporters covering the case and experts in crime scene investigation and forensic psychology.

Both sides have now officially rested their cases and testimony has concluded in the trial.

Judge William Sullivan dismissed the jury with instructions to return tomorrow with an open mind for closing arguments.

The judge scheduled a charging hearing with the prosecution and the defense for 2:30 p.m. ET today.

Questioning Saathoff on redirect, the prosecution referred to the 911 call Patrick Clancy made upon finding Clancy in the moments after she attempted suicide and whether she was able to speak.

Yesterday, Reddington called into question a previous witness’ assertion that Clancy spoke to her then-husband when he found her, since she was able to communicate only with grunts at the time of the 911 call.

Saathoff said today that it's possible she was able to speak to Patrick Clancy and subsequently lost the ability to speak, as people who are injured — and especially those who have overdosed — can deteriorate or change their state very quickly.

As part of its redirect examination, the prosecution asked Saathoff about Clancy's calls to a suicide hotline.

He confirmed in his testimony that Clancy reported having suicidal ideation to the hotline but that since she did not have a plan to carry out a suicide, the hotline determined she was not a candidate for hospitalization.

He also confirmed that the hotline did not hang up on Clancy or turn her away, as Reddington had suggested during his questioning.

"They sent her resources and recommended a day program and a partial hospitalization program or an inpatient program, correct?" the prosecution asked.

"Correct," Saathoff said.

The defense has finished cross-examination of Saathoff, the final witness of the weekslong trial.

Reddington read to Saathoff the opening statement from prosecutors, which accused Clancy of manipulating her providers by seeking quick fixes, by disengaging from treatments she didn't like and by making a deliberate choice that she did not want to try anymore.

"Do you agree that it would support your contention, sir, or it would not?" Reddington asked.

"I think that statement that you read really minimizes what she was going through," Saathoff said.

Reddington then announced he was done questioning Saathoff.

Reddington is focusing on the allegation that Clancy crushed pills and placed them in lemonade as part of her suicide attempt.

The defense questioned Saathoff based on his reading of the records. Saathoff testified that he was not aware of any residue related to the pills or a pill crusher tool found as part of the investigation.

"There's no investigation by the police to determine what was in that powder, right?" Reddington asked.

"Not that I'm aware of," Saathoff said.

The defense has resumed its questioning of forensic psychiatrist Gregory Saathoff after the morning recess.

Spectator rows were not as full this morning, with some empty seats now. Jurors seemed to be focused on testimony and taking notes.

There was some distraction when a woman with a dog came in to court. Clancy’s parents are here again, but there was no visible reaction from them.

Michael Musgrove, the father of Lindsay Clancy, listens to testimony today. Greg Derr / Pool via The Patriot Ledger

The judge has called a morning recess. It is not clear when court will be back in session.

Reddington has been discussing Clancy's reporting of having homicidal ideation before she acted on what she said were auditory hallucinations on Jan. 24, 2023.

He asked forensic psychiatrist Gregory Saathoff whether she reported these "dark, intrusive thoughts" to her doctors, to which Saathoff replied, "The homicidal ideation, as I understand, was just voiced to her husband and her mother."

"'Just voiced? Is that what you just said?" Reddington angrily responded.

"Just voiced, is that like talking about the Red Sox? She's talking about homicidal ideation of her children," he snapped.

The prosecution objected and the judge sustained.

Reddington presses Saathoff to answer whether it was reasonable for Clancy to decide against taking a medication due to the side effects.

The defense went over the effects of lamotrigine, which can include a severe reaction on the skin. It was characterized as a rash, but Reddington pushed Saathoff on the severity of the reaction, including blistering.

Reddington asked whether it was reasonable, given Clancy's experience as a nurse, that she might decline to take a drug. Saathoff took a long pause in response before stating that the benefits of the drug are "profound."

"Is that a reasonable decision for Lindsey to make, to say 'I don't wish to take that based on all the side effects'?" Reddington asked again.

"In her mind it was," the forensic psychiatrist eventually answered after another pause.

Lyndsay Clancy in court today. Greg Derr / Pool via The Patriot Ledger

A self-proclaimed livestreamer just walked into the courtroom with a small dog on a leash. The public portion of gallery fixated on their entry. The dog didn't have a visible service animal badge.

A dog accompanies a spectator into the courtroom today Greg Derr / Pool via The Patriot Ledger

Reddington questioned Saathoff on his history of treating people with postpartum psychosis, attempting to minimize the psychiatrist's expertise on the matter.

Saathoff maintained he has, detailing several cases he saw in the 1980s and 1990s. On Tuesday, Saathoff testified he had treated around half a dozen women with postpartum psychosis and wrote one of the first papers on the link between medication and the disorder.

That experience didn't satisfy Reddington, who asked, "Other than that...?"

Reddington repeatedly pressed Saathoff on whether he has written any articles about auditory hallucinations — which he has not.

Saathoff answered that he has read a number of peer-reviewed articles on the topic but conceded he had not penned any of them.

Defense attorney Kevin Reddington listens to Dr. Gregory Saathoff today. Greg Derr / Pool via The Patriot Ledger

Going through Saathoff's résumé, the defense is emphasizing the witness's work with various governments, foreign and domestic.

Reddington went over Saathoff's work with the FBI, the University of Virginia, the U.S. Air Force, and crisis management units for foreign states such as Canada, Jordan and Australia.

"Fair to say that you're a government man?" Reddington asked.

"Objection!" the prosecution interjected.

The objection to Reddington's comment was sustained.

It's now time for defense attorney Kevin Reddington to question the final witness. Already, he's pushing Saathoff on details of his compensation for taking on this case.

Saathoff explained that he is not being paid directly to serve as a witness. Instead, the state is paying the University of Virginia, where he works, as he receives his normal salary.

Reddington also noted, as he has for a number of prior witnesses, that Saathoff only saw Clancy via Zoom.

The jurors are locked in on the last day of testimony.

Thirteen jurors were writing notes as Saathoff said Clancy knew what she was doing when she killed her kids.

Saathoff maintained that Clancy "did have the capacity to appreciate right from wrong" on the night she killed her children.

Among the reasons he said he believes that, he said Clancy, just minutes before the killings, had the capacity to send her former husband on an errand and asked him to pick up dinner from a specific restaurant.

Forensic psychiatrist highlights series of decisions Lindsay Clancy made on night of killings

03:06

He also pointed to the fact that she acted when she was home alone, a time when she knew no one would witness — or intervene — with her plan, he said. The timing of it, when her former husband was not home, showed she had an awareness of time and made the decision to act while he was out, Saathoff said.

Choosing a weapon — exercise bands — that was readily available and nearby also showed she had an understanding of what she was doing, he said.

When asked about the amount of amitriptyline that Clancy was taking, Saathoff said it was a very low dose for an adult and would have even been safe for a child.

Amitriptyline is an antidepressant that Clancy's defense has argued helped push her mental state over the edge.

When asked if Clancy's 10 to 20 milligrams of amitriptyline is something that could be prescribed to a child, Saathoff responded, "Yes."

Saathoff explained how people in psychosis are able to conform their behavior to comply with law enforcement, even if command hallucinations are occurring.

For example, if someone is having hallucinations instructing them to do something that would break the law in the presence of a police officer, they are able to ignore the voices and not do the requested actions, he said.

"It’s possible for a person to choose not to engage in that behavior," he said.

Court kicked off today with the prosecution's continued questioning of Saathoff, who is affiliated with the FBI and University of Virginia.

Attention was immediately placed back on the voice Clancy said she heard on the night of Jan. 24, 2023, and how Saathoff believes Clancy maintained control over her actions because of what the voice said — and didn't say.

Forensic psychiatrist Dr. Gregory Saathoff testifies yesterday. Greg Derr / Pool via The Patriot Ledger

Saathoff pointed out that the voice only told Clancy to kill herself and her kids without giving instructions or details about how to carry out the killings. This, he said, means she was able to make decisions during this period of what the defense has said was psychosis, including choosing to bring the children to the basement, one by one, to kill them.

It is "surprising that she was able to accomplish all of this without any other kind of direction or plan," he said, adding that it "indicated that she had control of the sequence of what she was doing throughout."

Day 21 of Clancy's murder trial has begun. Today is expected to be the final day of testimony, with closing arguments slated for tomorrow.

"Once more unto the breach," Judge William Sullivan told the jury.

Dr. Gregory Saathoff, a forensic psychiatrist, was called back to the stand to finish questioning by the prosecution.

Nichelle Milford Cook, who has been attending the Clancy trial since Aug. 1, told NBC News outside of the courthouse this morning that she splits her time between Massachusetts and Texas.

Cook, who has a background in law but now works in maternal and postpartum healthcare, said her goal in going to watch the trial every day is to “find out where the gaps were” in Clancy’s healthcare and to try to figure out why this woman was driven to kill her three children.

"What can we do as a pathway to make sure that this doesn’t happen to another mother?" she said, referencing other cases across the U.S. that have similar circumstances and are set to go to trial soon.

Cook pointed to gaps she's seen in Clancy's mental healthcare, specifically calling out Dr. Jennifer Tufts, who treated Clancy as a psychiatrist when she started having mental health symptoms following the birth of her third child.

"I’ve been here just kind of watching, taking notes and doing research so that when I get back to Texas maybe some of the law firms or different people may want to see the research that I’ve done and maybe this will also help with postpartum care," she said.

At the center of a case that is gripping the nation stands the question: Is Lindsay Clancy criminally responsible for killing her three children? The prosecution and defense made clear the competing narratives they would present to the jury in their opening statements. Misty Marris and Steven Romo analyze what each side wanted jurors to believe before the first witness ever took the stand.

20:25

Did she do it? That’s not the question the jury is tasked with answering. Clancy doesn’t dispute that she killed her children before she tried to die by suicide on Jan. 24, 2023.

Instead, the trial seeks to answer: Is she criminally responsible for the killings?

Clancy has pleaded not guilty to three counts of first-degree murder, and her attorney argues she shouldn’t be held criminally responsible because she was mentally ill with postpartum psychosis.

People wait to enter the court this morning in Plymouth, Mass. Minyvonne Burke / NBC News

Forensic psychologist Kirk Heilbrun retook the witness stand Tuesday, testifying that Lindsay Clancy had a “moral awareness” about the “wrongfulness” of killing her children. NBC News legal analyst Misty Marris explains why this line of questioning is important for the prosecution’s case.

03:25

Three mothers who survived postpartum psychosis describe their experiences with the condition — and what they want people following the Lindsay Clancy trial to know.

“I honestly found my experience humbling because it was a reminder that psychosis does not care about your status or your age or your socioeconomic position,” Ayana Lage, 33, said about her 2020 experience. “It can truly happen to anyone.”

Read the full story here.

Clancy’s lawyers say a rare mental health condition caused her to kill her three children. So what is postpartum psychosis, and why is it so difficult to diagnose and treat?

The mental health condition at the center of the Lindsay Clancy trial

03:52

Last witness in Clancy trial takes the stand

04:06

The last witness took the stand yesterday. The prosecution’s witness told jurors that Clancy’s recollection of events was “inconsistent” with what she told other doctors and with the testimony of her former husband.

Plymouth County Superior Court Judge William Sullivan told jurors yesterday that they are likely to get the case by the end of the week.

Closing arguments are expected to begin tomorrow, and deliberations could start Friday.

“You’ve heard a lot of evidence, but you haven’t heard all of it, right? And like I said before, you haven’t heard the closing arguments of the attorneys,” Sullivan told the jury. “You haven’t heard the law that you’re going to have to apply to this. So you still have to keep an open mind.”